MEDICARE: DR. ELIZABETH ESTELLE CORWELL MILLER PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	RPH-025990	GA

General Provider Information

NPI Number	:	1710302153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ESTELLE CORWELL MILLER PHARMD

Provider Business Mailing Address
First Line	:	1133 EAGLES LANDING PKWY
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-5085
Country	:	US
Telephone Number	:	404-634-6584
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 JACOLYN PL NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3316
Country	:	US
Telephone Number	:	404-634-6584
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2014
Last Update Date	:	02/21/2014

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